Form:	Canary: PASS Follow-up Consent v2.0

CDE ID	CDE Description
* 421	EDRN Participant ID (Go To: 1319)
* 1319	Date participant signed consent form (MM/DD/YYYY): (Go To: 423)
* 423	EDRN Protocol ID (Go To: 422)
* 422	EDRN Site ID (Go To: 929)
* 929	EDRN Staff ID of the person who collected the data: (Go To: 2491)
* 2491	Has the participant authorized the use of their specimens for future cancer research? (Go To: 2492)
	Permissible Values (value): No (0)
	Yes (1)
* 2492	Has the participant authorized the use of their specimens for future research? (Go To: 2631)
	Permissible Values (value): No (0)
	Yes (1)
* 2631	Has the participant authorized future contact for research purposes? (Go To: 2824)
	Permissible Values (value): No (0)
	Yes (1)
	Not collected (2)
* 2824	Has the participant authorized sending his or her genetic information to one or more databases for future research? (Go To: 4736)
	Permissible Values (value): No (0)
	Yes (1)
	Not collected (2)
* 4736	Has the participant authorized the use of diagnostic tissue for research? (Go To: 2632)
	Permissible Values (value): No (0)
	Yes (1)
	Not collected (2)
* 2632	Consent form identifier: (Go To: 2633)
* 2633	Reason for follow-up consent: (Go To: 2635)
	Permissible Values (value): Protocol version change (1)
	IRB-required change (2)
	Other, specify: (97) (Go To: 2634)
* 2634	Reason for follow-up consent (Other, specify): (Go To: 2635)
* 2635	Protocol version number: (Go To: 4632)
* 4632	Consent status for long term follow-up: (Go To: 1097)
	Permissible Values (value): No long term follow-up allowed (0)
	Only medical record abstraction allowed (1)
	Participant contact and abstraction allowed (2)
	Not collected (90)
1097	Comments (do not include any participant identifiers) (Go To: End of Form)